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Extradural Haemorrhage - Coggle Diagram
Extradural Haemorrhage
Key Facts
SUSPECT this after head injury, conscious level falls or is slow to improve of there is a lucid interval
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Aetiology
MOST COMMONLY due to traumatic head injury resulting in fracture of the temporal or parietal bone causing laceration of the MIDDLE MENINGEAL ARTERY, typically after trauma to the temple
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Clinical Presentation
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Ipsilateral pupil dilates, coma deepens, bilateral limb weakness develops and breathing becomes deep and irregular - signs of brainstem compression
Severe headache, nausea and vomiting, confusion and seizures - due to raising ICP +/- hemiparesis with brisk reflexes
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Differential Diagnosis
Epilepsy, carotid dissection and carbon monoxide poisoning - fit with lucid period
Subdural haematoma, subarachnoid haemorrhage, meningitis
Diagnosis
CT head
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Shows hyperdense haematoma that is biconcave/lense shaped/lemon shaped and adjacent to the skull
- Blood forms a more rounded shape compared with the skittle-shaped subdural haematomas as the tough dural attachments to the skull keep it more localised
Skull X-ray
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Skull fracture increases extradural haemorrhage risk - so anyone with suspected fracture do urgent CT!
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